Locally Acquired Dengue Virus Infection in a Non-endemic Area

Dengue virus (DENV) infection occurs through the transmission of the virus via mosquito vectors that are largely endemic to subtropical or tropical regions in the world. Patients from non-endemic areas typically report recent travel history and sudden onset of high fever, accompanied by severe headache, retro-orbital pain, and nausea. We present a case of a patient with a locally acquired dengue fever infection in a non-endemic area in Southern California. An extensive medical evaluation was performed by multiple physicians in various healthcare settings, ultimately leading to this diagnosis. Though our patient's presenting constellation of symptoms was consistent with dengue fever, his lack of exposure to an area known to be endemic for DENV made this a surprising and extraordinarily challenging diagnosis. This case report demonstrates the importance of maintaining a high index of clinical suspicion for acute DENV infection in those presenting with an acute febrile illness and findings concordant with this diagnosis.